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Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

柴家科 盛志勇 杨红明

感染、炎症、修复2000,Vol.1Issue(2):66-73,8.
感染、炎症、修复2000,Vol.1Issue(2):66-73,8.

Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

柴家科 1盛志勇 1杨红明1

作者信息

  • 1. Clinical Department of Burns Institute, 304th Hospital, Beijing 100037
  • 折叠

摘要

Abstract

Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients' vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged;②The major cause related to burn wound sepsis was extensive burn injuries, with large areas of deep burn remaining open; ③Although wound swabs taken on admission revealed the presence of colonization by many pathogenic bacteria, Pseudomonas aeruginosa was one of the most frequent bacteria isolated from the subeschar tissue; ④The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than that after surgical intervention (P<0.05) ;⑤The lowest level of the inflammatory mediators was observed when the patients' conditions became stable, as compared with before surgical intervention (P<0. 001).These findings suggest that the clinical characteristics of burn wound sepsis are abrupt deterioration of the general condition and prominent septic symptoms, often complicated by MODS. The main cause of burn wound sepsis is the presence of a large area of open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Although success in treating these patients is the result of appropriate application of multiple treatments, early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wound play a crucial role in the successful treatment of patients complicated by burn wound sepsis. Other treatments are adjuvant but also important.

关键词

Burns Burn wound sepsis Characteristics Treatment Experience

Key words

Burns Burn wound sepsis Characteristics Treatment Experience

引用本文复制引用

柴家科,盛志勇,杨红明..Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases[J].感染、炎症、修复,2000,1(2):66-73,8.

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